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Background Traditional Chinese medicine (TCM) has gained widespread application in treating chronic heart failure (CHF) secondary to coronary heart disease (CHD). However, the sound clinical evidence is still lacking. Corresponding clinical trials vary considerably in the outcome measures assessing the efficacy of TCM, some that showed the improvement of clinical symptoms are not universally acknowledged. Rational outcome measures are the key to evaluate efficacy and safety of each treatment and significant elements of a convincing clinical trial. We aimed to summarize and analyze outcome measures in randomized controlled trials (RCTs) of TCM in treating CHF caused by CHD, subsequently identify the present problems and try to put forward solutions. Methods We systematically searched databases including Embase, PubMed, Cochrane Library, CBM, CNKI, VIP and Wanfang from inception to October 8, 2018, to identify eligible RCTs using TCM interventions for treating CHF patients caused by CHD. Cochrane Database of Systematic Reviews (CDSR) was searched to include Cochrane systematic reviews (CSRs) of CHF. Two authors independently assessed the risk of bias of the included RCTs according to the Cochrane Handbook. Outcome measures of each trial were extracted and analyzed those compared with the CSRs. We also evaluated the reporting quality of the outcome measures. Results A total of 31 RCTs were included and the methodology quality of the studies was generally low. Outcome measures in these RCTs were mortality, rehospitalization, efficacy of cardiac function, left ventricular ejection fraction (LVEF), 6 min’ walk distance (6MWD) and Brain natriuretic peptide (BNP), of which mortality and rehospitalization are clinical end points while the others are surrogate outcomes. The reporting rate of mortality and rehospitalization was 12.90% (4/31), the other included studies reported surrogate outcomes. As safety measure, 54.84% of the studies reported adverse drug reactions. Two trials were evaluated as high in reporting quality of outcomes and that of the other 29 studies was poor due to lack of necessary information for reporting. Conclusions The present RCTs of TCM in treating CHF secondary to CHD did not concentrate on the clinical end points of heart failure, which were generally small in size and short in duration. Moreover, these trials lacked adequate safety evaluation, had low quality in reporting outcomes and certain risk of bias in methodology. For objective assessment of the efficacy and safety of TCM in treating CHF secondary to CHD, future research should be rigorous designed, set end points as primary outcome measures and pay more attention to safety evaluation throughout the trial.

To describe and analyze the status quo of cardiovascular clinical practice guidelines or expert consensuses including both Chinese medicine (CM) and integrative medicine, through systematic literatures searching and quality assessment. Data bases including Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, Wanfang Data, China Science and Technology Journal Database were searched for published CM or integrative cardiovascular clinical practice guidelines or expert consensuses. The website www. medlive.cn was also retrieved as supplementary. The clinical practice evaluation tool AGREE II was used to assess the quality of included guidelines or consensuses. A total of 31 relevant clinical practice guidelines or expert consensuses were included, covering diagnosis, treatment, Chinese patent and patient fields. Common cardiovascular diseases like coronary heart diseases, heart failure and arrhythmia were also involved. Through analysis it was found that both the quantity and quality of included guidelines have been improved year by year. A total of 4 evidence-based clinical practice guideline has been found, one of which was a guideline project plan. Except that, the remaining 27 reports were all consensus-based guidelines. The scores of each field, from highest to lowest, were clarity of presentation (58%), scope and purpose (54%), stakeholder involvement (28%), rigor of development (21%), applicability (13%) and editorial independence (8%). Although clinical practice guidelines in cardiovascular domain of Chinese have gained increasing concern, with both quantity and quality improved, there is still huge gap in methodology and reporting standards between CM guidelines and international ones. On the one hand, it is essential to improve and standardize the methodology of developing CM guidelines. On the other hands, the evaluation system of evidence and recommendation with CM characters should be developed urgently.

Background No treatment has convincingly been proven to be beneficial for microvascular obstruction (MVO) in patients with ST-elevation myocardial infarction (STEMI). Several studies have described the effects of Danhong Injection. However, evidence of a rigorously designed verification study is still lacking, and the intervention timing of Danhong Injection is uncertain. Methods The DIRECTION study is a multicenter, prospective, randomized, evaluator-blind study. A total of 336 patients with STEMI receiving percutaneous coronary intervention (PCI) will be randomly assigned to conventional treatment, the preoperative Danhong Injection, or the postoperative Danhong Injection. The primary outcome is rate of ST-segment resolution (STR) ≥ 70% at 90 min after PCI. The secondary outcomes are the degree of STR, Thrombolysis in Myocardial Infarction (TIMI) flow grade, TIMI myocardial perfusion grade, left ventricular ejection fraction, N-terminal prohormone brain natriuretic peptide, high-sensitivity C-reactive protein, and infarct size expressed as area under the curve for cardiac troponin I (cTnI) and for creatine kinase MB. The major adverse cardiovascular events and hospital readmission events will be recorded. Health quality will be assessed with the 12-item Short Form Health Survey. The safety outcomes include bleeding events, adverse events, and abnormal changes in routine blood tests. Psychological status and dietary patterns will be evaluated using Hamilton Depression Rating Scale and Food Frequency Questionnaire as the relevant indicators. Discussion This trial will evaluate the efficacy and safety of Danhong Injection, as well as its optimal timing of intervention to prevent MVO in patients with STEMI. Trial registration Chinese Clinical Trial Registry, ChiCTR1900021440. Registered on February 21, 2019.

The substitution of noble metal platinum catalyst is one of the important research contents for sustainable development and is also the key to the practical application of photoelectrochemical (PEC) hydrogen production. In this work, we loaded the 1T-2H mixed phase MoS2 on the hydrogenated anatase/rutile heterophase TiO2 (A-H-RTNA) by hydrothermal method to prepare a new MoS2/A-H-RTNA electrode material. The prepared material exhibited higher carrier density, lower PL intensity and higher conductivity than Pt/A-H-RTNA because 1T-MoS2 has more active sites and lower charge transfer resistance than Pt. With the bias voltage of −0.4 V, the optimized 16MoS2/A-H-RTNA as photocathode shows the largest PEC hydrogen production rate of 1840 mmol m−2 h−1, which is 2.9 and 2.2 times higher than those of A-H-RTNA (625 mmol m−2 h−1) and Pt/A-H-RTNA (848 mmol m−2 h−1), respectively. We innovatively used the prepared 16MoS2/A-H-RTNA film as counter electrode instead of Pt electrode to construct a PEC system without any noble-metal. The result demonstrates that the noble-metal-free MoS2 loaded on TiO2 electrode as counter electrode has 75% PEC activity of noble metal Pt electrode. This study develops a PEC method for hydrogen evolution, which no longer depends on precious metal platinum as cathode.

To systematic review the effect of Chinese medicine (CM) on no or slow reflow after percutaneous coronary intervention (PCI) in myocardial infarction (MI) patients. The PubMed, EMBASE databases, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, China National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Database (CBM), Wanfang Knowledge Service Platform (Wanfang Database) and Chinese Scientific Journal Database (VIP) were searched up to December 2017. Randomized controlled trials (RCTs) which evaluated the effect of CM therapies on no or slow reflow after PCI in MI patients were included. The primary outcome was the effect of reperfusion. Secondary outcomes were left ventricular ejection fraction, incidence of major adverse cardiovascular events and adverse effect. Ten RCTs covering 814 patients were included. Two studies revealed that the incidence of no or slow reflow was less in Shenmai Injection (参麦注射液) group than in the control group measured by thrombolysis in myocardial infarction (TIMI) ⩽ 2 (risk ratio=0.55, 95% confidence interval 0.38 to 0.81, P=0.003, I2=37%). Two studies indicated that Salvianolate Injection showed no additional benefit on no or slow reflow measured by corrected TIMI frame count compared with the conventional treatment (mean difference −4.24, 95% confidence interval −13.03 to 4.54, P=0.34, I2=86%). In addition, Tongxinluo Capsules (通心络胶囊), Danhong Injection (丹红注射液) and Xuesaitong Injection (血塞通注射液) may have the potential to reduce no or slow reflow measured during or after PCI in individual studies. Current evidence from RCTs are not sufficient to evaluate the effect of CM adjuvant therapies on no or slow reflow after PCI for MI patients. The included studies are limited by small sample size and unclear baseline conditions. Further rigorously designed researches and verification studies with sufficient number of patients are warranted.

ObjectivesTo examine heterogeneity of outcomes in protocols of clinical trials of Coronavirus Disease 2019 (COVID-19) and to identify outcomes for prioritization in developing a core outcome set (COS) in this field.DesignThis study is a review.Data sourcesDatabases of ICMJE-accepted clinical trial registry platform were searched on February 14, 2020.Eligibility CriteriaRandomized controlled trials (RCTs) and non-RCTs of COVID-19 were considered. Conditions of patients include common type, severe type or critical type. Interventions include traditional Chinese medicine (TCM) and Western medicine. We excluded trials that for discharged patients, psychological intervention and complications of COVID-19.Data extraction and synthesisThe general information and outcomes, outcome measurement instruments and measurement times were extracted. The results were analysed by descriptive analysis.Results19 registry platforms were searched. A total of 97 protocols were included from 160 protocols. For protocols of TCM clinical trials, 76 outcomes from 16 outcome domains were reported, and almost half (34/76, 44.74%) of outcomes were reported only once; the most frequently reported outcome was time of SARS-CoV-2 RNA turns to negative. 27 (27/76, 35.53%) outcomes were provided one or more outcome measurement instruments. 10 outcomes were provided one or more measurement time frame. For protocols of western medicine clinical trials, 126 outcomes from 17 outcome domains were reported; almost half (62/126, 49.21%) of outcomes were reported only once; the most frequently reported outcome was proportion of patients with negative SARS-CoV-2. 27 outcomes were provided one or more outcome measurement instruments. 40 (40/126, 31.75%) outcomes were provided one or more measurement time frame.ConclusionOutcome reporting in protocols of clinical trials of COVID-19 is inconsistent. Thus, developing a core outcome set is necessary.Strengths and limitations of this study1.This review is the first to describe variation in outcomes, outcome measurement instruments and outcome measurement time reporting in clinical trials for Coronavirus Disease 2019 (COVID-19).2.All the database of ICMJE-accepted clinical trial registry platform were searched, and randomized controlled trials and observational studies were considered.4.The aim of this review was to provide a list of outcomes for clinical trials of COVID-19, both interventions of Traditional Chinese Medicine and western medicine were considered.5.When the searching was conducted, no clinical trials were registered by countries out of China, so all of included protocols were from China.

Introduction. TCMI with the effect of Liqihuoxue and Yiqihuoxue has been applied as complementary therapies during the perioperative period of PCI for patients with ACS, while the recommended time points and plans of TCMI are still short of the support of evidence-based medicine. Methods. A systematic review and meta-analysis was conducted to evaluate the clinical efficacy and safety of TCMI on patients with ACS during the perioperative period of PCI. RCTs were searched based on standardized searching rules in seven medical databases from the inception up to August 2019. Two reviewers conducted the study selection, data extraction, and quality analysis independently. Data were analysed with the support of software RevMan and Stata. Results. A total of 68 articles with 6,043 patients were enrolled. The result of meta-analysis showed that the TCMI combined with western medicine was superior to the western medicine alone on clinical efficiency (before the PCI, before and after the PCI, or overall, P<0.05), the occurrence of MACE (myocardial infarction and stenocardia: before the PCI, before and after the PCI, or overall, P<0.05; arrhythmia: before and after the PCI, P<0.05), and the level of inflammatory factors (hs-CRP: before the PCI, before and after the PCI, or overall, P<0.05; IL-6: after the PCI, P<0.05). The TCMI with the effect of Liqihuoxue obtained more support compared with Yiqihuoxue based on the result of meta-analysis. Conclusions. TCMI with the effect of Liqihuoxue or Yiqihuoxue combined with western medicine generally showed the potential advantage on the treatment of ACS during the perioperative period of PCI. However, the optimal time point of intervention and recommended plan based on the effect still needs more clinical evidence. We consider that the research of precise and standardized application of TCMI will be a promising direction for TCM in the future.

Background: Chinese patent medicine Tongxinluo capsule (TXL) is commonly used for cardio-cerebrovascular diseases. Previous research had demonstrated that TXL exhibited great clinical effects on the treatment of acute myocardial infarction (AMI), however there is a lack of systematic review. The purpose of this study was to evaluate the potential effectiveness and safety of TXL for secondary prevention in patients with AMI. Method: We searched 6 databases to identify relevant randomized controlled trials (RCTs) from inceptions to December 30, 2017. Two review authors independently assessed the methodological quality and analyzed data by the RevMan 5.3 software. The publication bias was assessed through funnel plot and Begg's test. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used for evaluating the quality of evidence. Results: We included 19 RCTs in this review and performed a meta-analysis based on 16 studies. There were statistical differences of TXL treatment group in reducing primary cardiovascular events (cardiac death [RR = 0.27, 95%CI: 0.08~0.95, I2 = 0%], recurrent myocardial reinfarction [RR = 0.38, 95%CI: 0.20~0.74, I2 = 0%], arrhythmia [RR = 0.44, 95%CI: 0.30~0.66, I2 = 0%], recurrent angina pectoris [RR = 0.34, 95%CI: 0.17~0.69, I2 = 0%]). TXL could improve cardiac function (LVEF [MD = 4.10, 95%CI: 3.95~4.25, I2 = 0%]), regulate blood lipid TC [MD = −0.66, 95%CI: −0.94 ~ −0.37, I2 = 74%], TG [MD = −0.38, 95%CI: −0.62 ~ −0.14, I2 = 70%], LDL-C[−0.40, 95%CI: −0.65 ~ −0.16, I2 = 88%), decrease the level of hs-CRP (4-week: MD = −0.78, 95%CI: −0.97 ~ −0.60, I2 = 20%; Over 4-week: MD = −1.36, 95%CI: −1.55 ~ −1.17, I2 = 20%). However, TXL has little effects on revascularization [RR = 0.45, 95%CI: 0.13~1.56, I2 = 0%], recurrent heart failure (RR = 0.83, 95%CI: 0.27~2.57, I2 = 0%), and HDL-C (MD = 0.14, 95%CI: 0.00 ~0.29, I2 = 73%). Furthermore, TXL treatment group was more prone to suffer gastrointestinal discomfort. Conclusion: Chinese patent medicine TXL seemed beneficial for secondary prevention after AMI. This potential benefit needs to be further assessed through more rigorous RCTs. Systematic review registration number in the PROSPERO register: CRD42017068417.

The first corrosion detection for the large grounding grid of a 220kV substation was performed based on electrical impedance tomography (EIT) technology. The impedance value of grounding grid branch which represented the corrosion state of metal was calculated using the current and voltage data acquired on-site through injecting a direct current from one down conductor and collecting voltage data from other down conductors. The results indicated that the impedance increase ratio of the No.143 grounding grid branch in test area D was higher than the warning value (>15 times), indicating a breakage has occurred on this grounding grid branch. The two-dimension corrosion image of the whole underground grounding grid was calculated and drawn accurately and visually using the corrosion diagnosis software. The corrosion rate of carbon steel was monitored in the serious corrosion area later, to realize the online corrosion monitoring of grounding grid metal. EIT technology realized the underground grounding grid statues visible exhibition, and could be used to detect the corrosion state, corrosion area and failure location of the underground grounding grid rapidly and effectively. This could reduce the blindness of corrosion detection for grounding grid and provide guidelines on the corrosion maintenance of underground grounding grid in large substation.

Purpose – The purpose of this study was to investigate the corrosion of rusted carbon steel in dilute NaCl solution, with the purpose of exploring the effect of the rust layer on metal corrosion and establishing a corrosion model for rusted iron. Design/methodology/approach – The corrosion behavior of rusted carbon steel in dilute NaCl solution was studied by means of weight-loss determinations, scanning electron microscopy, Raman spectrometry and electrochemical techniques. Findings – The results indicated that carbon steel had a similar corrosion behavior in all three NaCl solutions. The iron rust, which consisted of a thin γ-FeOOH layer and a thick Fe3O4 layer, can facilitate the corrosion process of carbon steel via reduction of γ-FeOOH and the large area cathode of Fe3O4. Hence, the corrosion rate of carbon steel was accelerated significantly and finally was determined by the limiting diffusion rate of oxygen. Originality/value – A corrosion model of rusted carbon steel was established, suggesting that iron rust formed in all slightly acidic waters with low alkalinity probably promotes the corrosion of carbon steel. Anti-corrosion measures for iron in this type of solution, such as desalination water, should be aimed to reduce the promotional effect of the rust layer on metal corrosion.

In order to develop highly efficient visible-light-driven photocatalysts, bismuth tungstate (Bi2WO6) was incorporated with reduced graphene oxide (RGO) via an ionic liquid-assisted hydrothermal process. The photocatalytic activities of the as-prepared samples were evaluated by photocatalytic degradation of a rhodamine B aqueous solution under visible light irradiation. Compared with pure Bi2WO6, all the as-prepared RGO–Bi2WO6 composites exhibited significantly enhanced photocatalytic performances for the degradation of rhodamine B. Significantly, the optimum photocatalytic degradation efficiency of RGO–Bi2WO6 composites prepared in the presence of the ionic liquid was about 1.9 times higher than that of Bi2WO6–RGO composites prepared without using the ionic liquid. The excellent photocatalytic performances of RGO–Bi2WO6 composites were correlated with the surface area, light absorption and the separation efficiency of photoinduced electrons and holes. Moreover, the possible mechanism of the enhanced photocatalytic activity for the RGO–Bi2WO6 photocatalyst was proposed on the basis of the experimental results.

PurposeThe purpose of this paper is to explore the long‐term corrosion behavior of carbon steel in 3% NaCl solution and evaluate the effect of rust layer on the corrosion process.Design/methodology/approachThe corrosion behavior of rusted carbon steel in 3% NaCl solution was studied by means of infrared spectroscopy (IR) and electrochemical impedance spectroscopy (EIS).FindingsThe results indicated that the corrosion of carbon steel was affected by chloride ion in initial immersion and then controlled by the rust layer. The rust layer consisted of a thin outer layer (γ‐FeOOH layer) and a thick inner layer (Fe3O4 layer). The outer rust layer facilitated the cathodic process via reduction of γ‐FeOOH, while the inner rust layer provided a large cathode area and oxygen could be reduced on its surface. As a result, the corrosion rate of carbon steel was determined by the limiting diffusion rate of oxygen and stabilized at a high value.Originality/valueThe corrosion model of rusted carbon steel in 3% NaCl solution was established. It is probable that the iron rust in all slightly acidic water with low alkalinity can promote the corrosion process via reduction of γ‐FeOOH. Anti‐corrosion measures for iron in this type of solutions should be aimed to reduce the promoting effect of rust layer on the metal corrosion. The NaCl solution prepared from tap water is more suitable for the substitution of artificial water than that prepared from deionized water.

Prediction of breakdown voltage of transformer oil has a great significance to the fault diagnosis and daily maintenance of transformer. Based on the correlation of performance parameters of transformer oil and the prominent fault-tolerance, non-linear approximation, and self-learning capabilities of BP neural network, this paper constructed a prediction method of breakdown voltage via multi-parameter correlation under the development environment of Matlab. Through examining the routine monitoring data of transformer oil by gray correlation analysis, this paper excavated some parameters which have strong correlation with breakdown voltage. Then a relational model of breakdown voltage and those parameters was further constructed using BP neural network. The clustering centers used to train network were acquired through clustering the original monitoring data samples with fuzzy C-means clustering algorithm. This method which uses clustering centers to train network can resolve natural problems of neural networks caused by large sample capacity, such as complication of net structure, inferior astringency, poor generalization ability, and so on. Test results show that the relative errors between predicted values and real values are all less than 10%, which indicates the significant practical values of this model.

Prediction of breakdown voltage of transformer oil facilitates the early fault diagnosis, prevention and treatment of transformer. In this article, a prediction method of breakdown voltage via multi-parameter correlation was proposed considering the lack of research in this field. Through examining the routine monitoring data of transformer oil by gray correlation analysis, some parameters which have strong correlation with breakdown voltage were excavated, then a relational model of breakdown voltage and those parameters was further constructed using back-propagation neural network, since BP neural network has prominent fault-tolerant, non-linear approximation, and self-learning capabilities. The clustering centers which were used to train network were acquired through clustering the original monitoring data samples with fuzzy C-means clustering algorithm. The adoption of this method can resolve natural problems of neural networks caused by large sample capacity, such as complication of net construction, inferior astringency, poor generalization ability, and so on. Test results show that the precision of the prediction model is high and that the relative prediction errors of test samples are all less than 10%, which indicates the significant practical value of the model.